Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 1 ( January-February, 2021 ) > List of Articles

Original Article

Prevalence and Determinants of Postpartum Anxiety among Women Availing Health Services at a Rural Maternity Hospital in South India

Christy Maria, Naveen Ramesh, Avita R Johnson, Priya M Prince, Aleena Rodrigues, Anu Lekha, Anju Elias

Keywords : Anxiety, Depression, Hospital, Postpartum, Rural

Citation Information : Maria C, Ramesh N, Johnson AR, Prince PM, Rodrigues A, Lekha A, Elias A. Prevalence and Determinants of Postpartum Anxiety among Women Availing Health Services at a Rural Maternity Hospital in South India. J South Asian Feder Obs Gynae 2021; 13 (1):1-5.

DOI: 10.5005/jp-journals-10006-1858

License: CC BY-NC 4.0

Published Online: 00-02-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Introduction: Anxiety is defined as a feeling of worry, nervousness, or unease about something with an uncertain outcome. Though depression is the leading cause of disability for women worldwide, there is a paucity of literature regarding postpartum anxiety among rural Indian women. Aims and objectives: To estimate the prevalence of postpartum anxiety and its determinants among women availing health services at a rural maternity hospital in the Ramanagara district of south Karnataka. Materials and methods: The study included 231 postpartum women from the second day of delivery to 6 months postpartum attending the rural maternity hospital. Results: Our study consists of 46.7% of women belonging to 20–24 age-group and 76.2% belonging to lower middle/lower class. Prevalence of mild postpartum anxiety was found to be 88.17%, generalized anxiety being 10%, and severe anxiety as 1.3%. There was significant association between postpartum anxiety and depression (p-value = 0.00). Conclusion: There is a need for screening women for mental ill-health during and after pregnancy. National programs should include these assessments at the primary healthcare level.

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  1. Jordan V, Minkel M. Journal on behavioural health consultant, vol. 68, No. 3. Berkeley: University of California, pp. 10–15.
  2. Watson JP, Elliot SA, Rugg AJ, et al. Psychiatric disorder in pregnancy and the first postnatal year. Br J Psychiatry 1984;14:453–462. DOI: 10.1192/bjp.144.5.453.
  3. Teixeria JM, Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ 1999;318:153–157. DOI: 10.1136/bmj.318.7177.153.
  4. Murray L, Cooper P. Effects of postnatal depression on infant development. J Child Psychol Psychiatry 1997;77(2):99–101. DOI: 10.1136/adc.77.2.99.
  5. Mina S, Balhara YPS, Verma R, et al. Anxiety and depression amongst the urban females of Delhi in ante-partum and post - partum period. Delhi Psychiatry J 2016;15(2):31–35. DOI: 10.4103/0253-7176.175101.
  6. Harvard Medical School. National Comorbidity Survey (NCS). 2017. Retrieved from Data Table 2: 12-month prevalence DSM-IV/WMH-CIDI disorders by sex and cohort
  7. Agbaje OS, Nnaji LR. Depressive and anxiety symptoms and associated factors among postnatal women in Enugu-North senatorial district south east Nigeria: a cross sectional study. Arch Public Health 2019;77:1. DOI: 10.1186/s13690-018-0329-6.
  8. Deborah G, Leslie M, Leighann F, et al. A study comparing Asians, Caucasians and native Hawaiian women. Master Health J 2006;16:34–37. DOI: 10.1007/s10995-006-0165-0
  9. Spitzer RL, Kroenke K, Williams JBW, et al. A brief measure for assessing generalized anxiety disorder. Arch Inern Med 2006;166:1092–1097. DOI: 10.1001/archinte.166.10.1092.
  10. Shlomi Polachek I, Huller Harari L, Baum M, et al. Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression and postpartum PTSD. Isr J Psychiatry Relat Sci 2014;51:128–134. PMID: 25372562
  11. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 1987;150(6):782–786. DOI: 10.1192/bjp.150.6.782.
  12. Hamid F, Asif A, Haider I. Study of anxiety and depression during pregnancy. Pak J Med Sci 2008;24(6):861–864. Available from :
  13. O’Hara M, Swain A. Rates and risk of postpartum depression - a meta-analysis. Int Rev Psychiatry 1996;8:37–54. DOI: 10.3109/09540269609037816.
  14. Buist A, Westley D, Hill C. Antenatal prevention of postnatal depression. Arch Women's Mental Health 1999;1:176–173. DOI: 10.1007/s007370050024
  15. Matthey S, Kavanagh DJ, Howie P, et al. Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes. J Affect Disord 2004;79:113–126. DOI: 10.1016/S0165-0327(02)00362-2.
  16. Dennis CL. Psychosocial and psychological interventions for prevention of postnatal depression. Br Med J 2005;331:15–23. DOI: 10.1136/bmj.331.7507.15.
  17. Fairbrother N, Janssen P, Antony MM, et al. Perinatal anxiety disorder prevalence and incidence. J Affect Disord 2016;200:148–155. DOI: 10.1016/j.jad.2015.12.082.
  18. Zlotnick C, Miller IW, Pearlstein T, et al. A preventive intervention for pregnant women on public assistance at risk for postpartum depression. Am J Psychiatry 2006;163:1443–1445. DOI: 10.1176/ajp.2006.163.8.1443.
  19. Paul IM, Downs DS, Schaefer EW, et al. Postpartum anxiety and maternal-infant health outcomes. Pediatrics 2013;131:1218–1224. DOI: 10.1542/peds.2012-2147.
  20. Chandran M, Tharyan P, Muliyil J, et al. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry 2002;181:499–504. DOI: 10.1192/bjp.181.6.499.
  21. BC Reproductive Mental Health Program and Perinatal Services BC. Best practice guidelines for mental health disorders in the perinatal period. 2014. Available at: (accessed 5 June 2020).
  22. Tietz A, Zietlow AL, Reck C. Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behavior. Arch Womens Ment Health 2014;17:433–442. DOI: 10.1007/s00737-014-0423-x.
  23. Reck C, Struben K, Backenstrass M, et al. Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 2008;118(6):459–468. DOI: 10.1111/j.1600-0447.2008.01264.x.
  24. Tiffany Field. Postpartum anxiety prevalence, predictors and effects on child development: a narrative review. Infant Behav Dev 2017;51:24–32. DOI: 10.1016/j.infbeh.2018.02.005.
  25. Simavli S, Kaygusuz I, Gumus I, et al. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. J Affect Disord 2014;156:194–199. DOI: 10.1016/j.jad.2013.12.027.
  26. The World Health Report 2005. Make every mother and child count. Chapter. 4. Attending to 136 million births, every year, pp. 61–77. Available from: (accessed 5 June 2020).
  27. National Mental Health Survey of India, 2015-2016. Prevalence patterns and outcomes. Supported by Ministry of Health and Family Welfare Government of India and Implemented by National Institute of Mental Health and Neuro – Sciences. Bengaluru: In Collaboration with Partner Institutions; 2015–2016.
  28. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord 2016;191:62–77. DOI: 10.1016/j.jad.2015.11.014.
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